A SALUTE TO YOUR GLUTES

The powerhouse of your body

You know how the old saying goes: What’s good for the glutes is good for the Goner. This month, we will pay extra attention to your backside!

 

The gluteal complex is remarkable. It doesn’t matter what type of athlete or human being you are, your glutes are more important than you may realize. They are the strongest and biggest muscle of the body, and boy can they multitask. They do so much: extend the hip, laterally rotate the hip, abduct the  hip, posteriorly tilt the pelvis, aid in force closure of sacroiliac (SI) joint (giving that joint some much needed stability),  transfer force through the tensor fasciae latae and IT band, (and because the IT band inserts on the lateral tibial condyle, this insertion point connects the gluteus maximus with the lower limb, below the knee).  So they help control the lower limb by eccentrically controlling adduction and internal rotation of the thigh. The glutes also provides lower back stability through its connection with the erector spinae and thoraco-lumbar fascia. Due to their natural strength and the leverage advantage they have over your legs, the glutes should always be the primary muscles that drive lower body movement. Not only does this include more ballistic activities like running and jumping, but also walking. Yeah, that’s right, we said walking. Do you feel your glutes working when you are simply walking around during the day? Go ahead and give it a test.

We have never once assessed someone and thought “wow, your glutes are just way too strong, and fire perfectly, we may want to back you off of those glute exercises.” No, not ever has that happened. Most often, people are more likely to have inhibited glute function (the neural input to the muscle is lowered, so other muscles tend to take over the job that the glutes are supposed to do). We are constantly noticing that there is a direct association between quad dominant athletes and back pain.  An athlete with no butt is often destined for back issues once they begin intense work. Again we never want to scare you into thinking you will have an injury, rather, we want to inform you! We want to help you move optimally, and avoid injury. We want you to continue being amazing goners. (Because, really, we don’t tell you enough, you guys are inspiring to say the least).

 

The good news: The glutes are usually dormant and underused, but have TONS OF POTENTIAL.

So let’s get into a bit more detail about this powerhouse structure.  The gluteal complex is comprised of three muscles working individually but also synergistically in the posterior lateral hip compartment; glute maximus, glute medius, and glute minimus.

Glute max: the largest muscle in the human body, and is the most superficial of the muscles in the hip. It originates at the ilium, lumbar fascia, sacrum, and the sacrotuberous ligament, and inserts at the gluteal tuberosity of the femur, and the iliotibial tract. The glute max is an extremely influential muscle, and a very powerful hip extensor. It also assists in the abduction and external rotation of the femur, and the stabilization of the knee. It helps to control and centralise the femur in the hip socket.. It provides pelvic and SI joint stability.  (Ok goners, do you remember last month’s emphasis? All that important talk about the spine and pelvis ties in with glute function). The glute max helps to control flexion of the trunk, and helps to control stabilization of the trunk. Want to test it right now? Go ahead and get into a push up position, and first, relax your glutes, go into your push up, and see how your lower back feels. Now, squeeze your glutes and try the same thing. Feel any difference? When your glutes work properly, they help to stabilize the pelvis, which keeps your back from taking the brunt of the work.

Glute medius: the primary role of the gluteus medius is hip abduction (raising leg out to the side or stabilizing the hip during gait).  The anterior fibers of the gluteus medius assist in hip internal rotation whereas the posterior fibers of the gluteus medius assist in hip external rotation.  It originates at the outer surface of the ilium between the posterior and middle gluteal lines, underneath the glute maximus, and inserts at the greater trochanter of the femur.

Glute minimus: is the smallest muscle of the group and also the deepest. It originates at the outer surface of the ilium between the middle and inferior gluteal lines, and inserts at the greater trochanter of the femur. The glute medius and glute minimus muscles are incredibly influential, and their importance cannot be underestimated. The medius and minimus are the main stabilizers of the pelvis and femur, and externally rotate and abduct the femur. Both of these muscles are integral to the alignment of the hips, knees, and ankles, and feet, and are vital for injury prevention, overall performance, particularly in unilateral activities and exercises.

 

So, what happens when our glutes don’t work?

Weak or delayed activation of the gluteus max and medius is a root cause for many injuries and chronic pain. Dysfunctional glutes can play a role in many muscles becoming extremely overactive to provide the pelvis and femur with the stability that it is lacking.

• Low back pain: Gluteus medius weakness and gluteal muscle tenderness are common symptoms in people with chronic non-specific low back pain (Cooper et al. 2016).  If your glutes do not have the extension strength into terminal range, then extension movements may occur in the lumbar spine via some anterior pelvic tilt.

• An athlete with weak glutes and/or excessive anterior pelvic tilt will often display quad dominant lifting in exercises that are supposed to be hip-dominant, poor recruitment of the posterior chain, and overextension of the back in the squat, deadlift, and many other movements. If this exercise technique continues,  faulty movement patterns are ingrained and sometimes exacerbated, good glute development never shows, and an annoying lower back pain might start appearing.

• The glutes aid in force closure of the sacroiliac (SI) joint, giving that joint stability: So, if the glutes aren’t doing their job, your SI joint could be lacking stability (Barker et al. 2013).  If you want to minimize the risk of low back pain and injury, in addition to maximizing performance, make sure you train the glutes hard so they can effectively stabilize the SI joint and prevent aberrant motion from occurring.

• Hamstring strains: If an athlete has delayed gluteus maximus activity, the hamstring muscles can become dominant during hip extension, which can cause hamstring strains. A lot of athletes that pulled a hamstring keep suffering re-injuries despite their focus and efforts to strengthen the hamstrings. They are reinforcing a compensation pattern instead of reactivating their inhibited glutes.

• Anterior hip pain: Decreased force production from the gluteus maximus during hip extension is associated with increased anterior translation of the femur in the acetabulum (Lewis et al. 2007). The increased femoral anterior glide could lead to increased force and wear and tear on the anterior hip joint structures.

We tend to adopt positions that allow us to “hang” on our tissues. We inherently search for stable positions, but creating stability muscularly is more metabolically expensive, so we hang on the “passive” structures like ligaments and joint end-range. This obviously is not an optimal way to move, and we hope that we have hammered that idea into you all by now. So, what do we want to teach you? To establish motor patterns to spare your back and activate your glutes.

 

Let’s look further down the chain:

The vast majority of glute fibers insert into fascia. The glute max will influence the biomechanics of the entire leg musculature through myofascial force transmission.  

• Knee pain: Inhibited glutes can lead to poor control of the femur, leading to knee pain.  If an athlete does not have sufficient glute strength, hip extension range of motion, or poor control of pelvic neutral, they may dump into the quads, putting extra strain on  the knee (Rane, Bull 2016). Weak glutes can also lead to internally rotated femurs, or a knee valgus position (where the knees cave in, putting strain and stress on certain ligaments and muscles). Of course, following the chain down, this could potentially lead to an ankle collapse as well (Goo et al. 2016).

• IT band syndrome: The glute max has a major insertion into the fascia lata, so large that the iliotibial tract could be considered a tendon of insertion of the gluteus maximus. So, dysfunctional glutes can lead to a dysfunctional IT band (Stecco et al. 2013).  Athletes with IT band syndrome have weaker hip abduction strength in the affected leg compared with their unaffected leg and unaffected athletes (Fredericson et al. 2000). Additionally, symptom improvement with a successful return to the preinjury training program parallels improvement in hip abductor strength.

• Calf/achilles pain: If your glutes are not properly getting you into hip extension, other muscles will try to do it’s job. Have you ever had pain in your calf or achilles? Or perhaps an injury in your groin? The calves (and other muscles like adductor magnus, hamstrings) will all try to extend the hip if the glutes are not doing their job, potentially getting pissed at all the extra work they are doing (Franettovich et al. 2014).

 

So, what is the best way train the glutes?

Because the glutes are involved in such a wide range of movements, glute hypertrophy cannot be maximized by any one exercise. So, you know how we like to do it here at Paragon: We will put you through a variety of movements (with the underlying goal of glute activation). And as always, we will focus on high quality movements. Here are a few examples: (with some research quotations in bold to help explain why we do certain movements. If you want to read further on the glutes, check out our references, there is some great info there).

• Glute bridges and hip thrusts (Hip extension in varying angles of hip abduction and hip external rotation).  “The results of this study suggest that bridging with isometric hip abduction using the Thera-Band can be implemented as an effective method to facilitate gluteus maximus muscle activity and reduce the anterior pelvic tilt angle” (Choi et al. 2014).

• Hip abduction  “The results of this study suggest that side lying hip abduction with medial rotation can be used as an effective method to increase glute med activation and to decrease TFL activity during hip abduction exercises.” (Lee et al. 2014)

• Hip external rotation (in varying angles of hip flexion)

• Pelvic posterior tilt (PPT is actually similar to hip extension as far as the head of the femur and the acetabulum are concerned)   “Performing posterior pelvic tilt during isolated hip extension appears to cause greater gluteus maximus EMG amplitude than performing isometric hip extension in anterior pelvic tilt.” (Beardsley 2016)

• Exercises that require single-leg balance, stability of the lumbo-pelvic region, hip extension or eccentric control of hip flexion

• The gluteus maximus is a mix of slow and fast twitch muscle, so we will use both high and low repetitions and/or high and low velocities (Beardsley 2016).

• We will aim to increase blood flow to hypoxic tissues (blood flow is decreased when we sit most of the day) and also to increase conduction velocity of nerve signaling (Rusin 2016)

• Another piece to the puzzle is to have abs and obliques that are strong enough to stabilize your spine and maintain optimal position of the hips as the hip flexors and glutes work.

• Exercises that work the relationship between the foot and ankle and the glutes:  “People suffering from ankle sprain injuries also have been shown to have reduced activation levels of the gluteus maximus.” (Webster, Gribble 2012)

• What you can do throughout your day to help out the glute situation: as you walk around throughout the day make an effort to engage your glutes at heel strike. Next, do the same thing but this time come up on the balls of your feet and off your big toe as you stride forward,- again trying to feel your glutes work. The foot is designed to roll to the big toe and from there the big toe and glute work together to propel you forward. When you tie the glutes and feet together in one movement, that is optimal gait movement. “Given the results of the present study, it can be suggested that strengthening the gluteus maximus while also performing exercises to correct the pronated foot is an effective method for achieving normal gait.” (Goo et al. 2016)

 

Ok Goners, one final note:

Athletes with strong glutes will be faster, more efficient and explosive in their movements than athletes with weaker glutes (Ellis et al. 2014). They will also have a better chance at warding off injuries.  We don’t want this cycle to plague you:

1. Weak external obliques allow pelvis to anteriorly tilt.

2. Anterior tilt causes shortening of the hip flexor complex.

3. A shortened anterior hip will inhibit gluteal strength and function.

4. Weak glutes and tight anterior hip will prevent proper hip extension and function.

5.  The lack of hip extension ability will be compensated for by the lumbar vertebrae or other musculature taking over, causing: injury/rehab/repeat.

 

So, get ready for some much needed glute work this month (ok, ok, we know we already do this to you constantly, but we want you to be informed as to why your glutes are always taking such a beating).  Now that you know the importance behind those suckers, it’s time to get stronger.

Like we always say: It’s the glutes that hold us together.

-Laurel Lippard

 

References:

Barker PJ, Hapuarachchi KS, Ross JA, Sambaiew E, Ranger TA, Briggs CA. Anatomy and biomechanics of gluteus maximus and the thoracolumbar fascia at the sacroiliac joint. Clin Anat. 2013; Aug 20

Beardsley, C. Strength and Conditioning Research. 2016. https://www.strengthandconditioningresearch.com/perspectives/

Boyle, M. Advances in Functional Training.  Training techniques for coaches, personal trainers and athletes.  2010, On-Target Publications.  

Choi SA1, Cynn HS2, Yi CH3, Kwon OY4, Yoon TL5, Choi WJ6, Lee JH7. Isometric hip abduction using a Thera-Band alters gluteus maximus muscle activity and the anterior pelvic tilt angle during bridging exercise. J Electromyogr Kinesiol. 2015 Apr;25(2):310-5. doi: 10.1016/j.jelekin.2014.09.005. Epub 2014 Sep 16.

Cooper NA1,2, Scavo KM3, Strickland KJ3, Tipayamongkol N3, Nicholson JD4, Bewyer DC4, Sluka KA3. Prevalence of gluteus medius weakness in people with chronic low back pain compared to healthy controls. Eur Spine J. 2016 Apr;25(4):1258-65. doi: 10.1007/s00586-015-4027-6. Epub 2015 May 26.

Ellis RG1, Sumner BJ2, Kram R3. Muscle contributions to propulsion and braking during walking and running: insight from external force perturbations. Gait Posture. 2014 Sep;40(4):594-9. doi: 10.1016/j.gaitpost.2014.07.002. Epub 2014 Jul 10.

Franettovich Smith MM1, Honeywill C, Wyndow N, Crossley KM, Creaby MW. Neuromotor control of gluteal muscles in runners with achilles tendinopathy. Med Sci Sports Exerc. 2014 Mar;46(3):594-9. doi: 10.  

Fredericson M1, Cookingham CL, Chaudhari AM, Dowdell BC, Oestreicher N, Sahrmann SA. Hip abductor weakness in distance runners with iliotibial band syndrome. Clin J Sport Med. 2000 Jul;10(3):169-75.

Goo YM1, Kim TH1, Lim JY1. The effects of gluteus maximus and abductor hallucis strengthening exercises for four weeks on navicular drop and lower extremity muscle activity during gait with flatfoot. J Phys Ther Sci. 2016 Mar;28(3):911-5. doi: 10.1589/jpts.28.911. Epub 2016 Mar 31.

Kim TW1, Kim YW2. Effects of abdominal drawing-in during prone hip extension on the muscle activities of the hamstring, gluteus maximus, and lumbar erector spinae in subjects with lumbar hyperlordosis. J Phys Ther Sci. 2015 Feb;27(2):383-6. doi: 10.1589/jpts.27.383. Epub 2015 Feb 17.

Lee JH1, Cynn HS2, Kwon OY3, Yi CH4, Yoon TL5, Choi WJ6, Choi SA7. Different hip rotations influence hip abductor muscles activity during isometric side-lying hip abduction in subjects with gluteus medius weakness. J Electromyogr Kinesiol. 2014 Apr;24(2):318-24. doi: 10.1016/j.jelekin.2014.01.008. Epub 2014 Feb 5.

Lewis, Cara L., Shirley A. Sahrmann, Daniel W. Moran, Anterior hip joint force increases with hip extension, decreased gluteal force, or decreased iliopsoas force. Journal of Biomechanics, Volume 40, Issue 16, 2007, Pages 3725-3731

Rane L1, Bull AM2. Functional electrical stimulation of gluteus medius reduces the medial joint reaction force of the knee during level walking.

Arthritis Res Ther. 2016 Nov 3;18(1):255.  

Stecco A, Gilliar W, Hill R, Fullerton B, Stecco C. The anatomical and functional relation between gluteus maximus and fascia lata. J Bodyw Mov Ther. 2013 Oct;17(4):512-7. doi: 10.1016/j.jbmt.2013.04.004. Epub 2013 May 11.

Rusin, J. https://drjohnrusin.com/top-5-glute-activation-techniques/ 2016.

Webster KA1, Gribble PA. A comparison of electromyography of gluteus medius and maximus in subjects with and without chronic ankle instability during two functional exercises. Phys Ther Sport. 2013 Feb;14(1):17-22. doi: 10.1016/j.ptsp.2012.02.002. Epub 2012 May 1.